Commissioning board draft structure revealed

The NHS Commissioning Board will have 3,500 staff and be led by a team of five executive directors, according to a leaked draft plan.

The document says the board-level executives will be the chief executive (Sir David Nicholson), nursing director, medical director, director of finance, performance and operations, and director of commissioning development.

In addition there will be five national professional leads who will each be responsible for one of the NHS Outcomes Framework “domains” and will report to the medical or nursing director.

There will also be five “national director” posts:

Director for patient engagement, insight and informatics

Director for strategy and transformation – “drive change and improvement”

Director for policy and corporate development – “corporate functions”.

Chief of staff – “core staffing functions [and…] fostering a new culture and new behaviours”

As well as reporting within their directorate commissioning board staff will report to one of the professional leads – with the aim of making “healthcare outcomes and professional and clinical leadership at the heart of the board’s business”.

The leaked draft by NHS chief executive Sir David Nicholson, produced after the government’s changes to its plans, includes an “initial broad assumption” that the total commissioning board staff will be 3,500. It says they will be carrying out functions previously performed by around 8,000 staff.

The document estimates around three-quarters of the staff will be “deployed locally”, under four sub-national units described as “commissioning sectors”. HSJ has reported two of the units will be London and the North (North West, North East, Yorkshire and the Humber).

Under each of the sectors there will be more local units but the document says: “We are not yet in a position to specify all the details of how these local teams will be organised.”

The document indicates senior appointments will be made in the summer, ahead of the board beginning operation in shadow form in October, as a special health authority.

Historically ingrained health inequalities in England won’t be reversed by measures in the long-term plan, which require bigger “political and societal” interventions, according to a public health expert whose work contributed to the plan.